Nancy Elam rode into Phoenix Police Department history in 1991 as the first woman to serve as a motorcycle officer on the force. Thirty-five years later, the retired trailblazer is facing Stage IV bile duct cancer that has spread to her liver, and she is doing it while also contending with denials from her health insurance coverage.
Elam broke through one of law enforcement's more visible gender barriers when she took to Phoenix's streets on two wheels, according to ABC15, which reported that “in 1991, Nancy made history and broke glass ceilings for women and law enforcement by becoming the very first woman to serve as a motorcycle officer for the Phoenix Police Department.” That same report says she is now attempting new treatments for her cancer while also dealing with health coverage denials.
It is not Elam's first fight with the disease. Several years before her current diagnosis, she had breast cancer separately, the station reported. Now, as she confronts a far more advanced illness, she says she is leaning on the people around her to get through it.
Leaning on a Blue Family
“I have the best help I could possibly get with friends, retirees, other officers,” Elam said, according to the station's report. She also offered a simple philosophy for coping with the diagnosis: “90% of it is your attitude.”
That support network extends beyond moral encouragement. Friends of Elam set up a fundraiser on her behalf through GoFundMe, writing that the campaign is being organized on her behalf as she fights the disease. The fundraiser page states that Elam is exploring a range of innovative treatment options to fight her Stage 4 liver cancer and continues to receive chemotherapy along with TOL, or Targeted Osmotic Lysis, treatments. The page also noted she was set to undergo a Y-90 procedure the following week, though it is unclear whether that procedure has since taken place.
A Broader Pattern of Denials in Arizona
Elam's experience with coverage denials is not occurring in isolation. Arizona's average in-network insurance denial rate reached 21% in 2023, higher than the 19% national average, according to Kaiser data cited by Cronkite News. Nationally, a Commonwealth Fund survey found that 17% of Americans reported their insurer had denied coverage for care their own physician had recommended, as reported by NBC News.
The hurdles can be especially steep for cancer patients specifically. A JAMA Network study cited in that same NBC News report found that 22% of cancer patients did not receive care their doctors had prescribed because of authorization delays or outright denials. A 2022 survey from the American Society of Clinical Oncology found that 42% of prior authorizations were delayed by more than a single business day, and 14% of those delays resulted in a serious adverse event for the patient, per the same report.
Other Arizona cancer patients have described similar battles with their insurers. Phoenix resident Gary Schmit said Anthem Blue Cross Blue Shield approved his tumor-removal surgery but denied coverage for the radiation treatment his Mayo Clinic medical team recommended afterward, according to AZFamily. Schmit said the radiation needed to start within six weeks of his surgery, which had already taken place about a month earlier, and that paying out of pocket for the treatment could cost him nearly $250,000.
Appeals Can Succeed, Data Shows
Denials are not always the final word. Research presented at the 2025 ASCO Quality Care Symposium found that three out of four people with cancer had to go through at least one prior-authorization process between 2022 and 2024, according to CURE Today. But the same reporting noted that ASTRO's 2024 survey found 73% of denied radiation oncology requests were ultimately overturned on appeal, and that among Medicare Advantage denials that were appealed, plans overturned 75% of their own denials at the first level.
The Arizona Department of Insurance says that when an insurer denies a service or claim as not medically necessary, it will forward the appeal to an independent review organization, which evaluates the appeal and communicates a decision, according to the state agency. It is not known what role, if any, that process has played in Elam's case.
For now, Elam's focus remains on treatment and on the community that has rallied around her. The woman who once broke barriers patrolling Phoenix streets on a motorcycle is now navigating a different kind of fight, supported by the friends, retirees and fellow officers she says have given her the best help she could possibly get.
